Rubella in Spain

The following background data on rubella in Spain are abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2] (Primary references available on request)

Vaccination of 11-year-old girls with monovalent Rubella vaccine was introduced in 1979.
– Routine MMR immunization was introduced in 1981.
– The second dose was advanced to age 3 to 6 years in 1999.

The following graph contrasts Rubella (MMR) vaccine uptake with rubella incidence in Spain [3]:

Graph Notes:
1. 658,767 cases of rubella were reported during 1982 to 1989.
2. Six fatal cases were reported during 1980 to 1994.
3. 267 hospitalizations for rubella (0.065 per 100,000) were reported during 1997 to 2006 – including 144 for intrpartum infection.
4. Eighteen cases of congenital rubella syndrome were reported during 1997 through 2011.

Seroprevalence surveys:
95% of the general population of Madrid (98.6% of women of childbearing age) (2000 survey)
96.4% of persons ages 17 to 36 (Barcelona, 1992 to 1993)
91.2% of women of childbearing age (Aragon, 2003 to 2007)
99.95% of pregnant women in Salamanca (2001)
93.4% of pregnant women (94.9% of indigenous women, 89% of immigrants) at the time of delivery (Catalonia, 2007 publication)
92% of pregnant immigrant women and 97.7% of native pregnant women (2006 to 2010)
95% of native-born pregnant women (2007 to 2008)
97.3% of pregnant women in Grenada (2007 to 2008)
88.3% of immigrant women in Catalonia (2009 publication)
95.7% of children ages 1 to 5 years, and 90.5% ages 5 to 14 in Castilla de Leon (2001 to 2002)
98.1% in Catalonia (1996)

Notable outbreaks:
1991 – An outbreak (175 cases) was reported in Cadiz.
2002 to 2003 – An outbreak was reported in Madrid – 19 cases (11 of whom were from Ecuador).
2004 to 2005 – An outbreak (460 suspect cases) was reported in Madrid region.
2005 – An outbreak (8 cases) was reported in Barcelona, among expatriates from Brazil.

References:
1. Berger SA. Infectious Diseases of Spain, 2012. 557 pp, 194 graphs, 2850 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-spain/
2. Berger SA. Rubella: Global Status, 2012. 314 pp, 447 graphs, 611 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/rubella-global-status/
3. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

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